This is the accurate account of my birth story told from the vantage point of my doula. It's a sad story in this country that many doctors do not see it fit for women to have their babies vaginally. I had to fight to have my daughter the way I wanted to have her. Here's the story:
11.06.2011
4:02pm – Sandra’s water breaks at 4:00 and she calls me to let me know.
6:38pm – I arrive at VA Hospital Center
6:44pm – First cervical check: 2cm, 40%, -3 station; discussion from hospital staff about “big baby”
7:15pm – Dr. H arrives. Uses the phrase, “…and everything like that,” when talking to Sandra. Does not give actual, evidence-based information. Goes over birth plan. Some memorable quotes:
“Once you have two sections, you’re always having sections.”
“If you try to push this baby out on your hands and knees you are guaranteed a 4th degree tear. On your back is easier for me.”
“When you get that nice epidural, you can push nicely and not tear…”
“If baby’s head is too big…”
Sandra asks the question: If I have another section, will you double suture?
Answer: We’ll see, but it won’t matter at that point because once you have two sections, it’s nothing but sections from here on out.
“I know you’re laboring, but in my head I’m treating you like a surgical patient.”
“I’m getting you ready for a C-section.”
Sandra was put on “contact isolation” due to previous MRSA infection and no proof in records of clean bill of health. Given a nasal swab culture, which wouldn’t be available until Tuesday. CI was confusing as they didn’t require John or I to put on gowns and masks (not that we would have) and the personnel that came in and out didn’t always put gowns on (I don’t recall a single mask being worn).
An IV was placed (time not noted) but was contested, as Sandra wanted more time to relax and was being pressured for blood work and fluids. Continuous EFM was required and baby’s HR looked great entire time.
7:47pm, 8:35pm, 9:20pm – Sandra peed
10:35pm – Pantygate: After a very uncomfortable situation in which the nurse, Charlie, (a woman nurse) attempted to forcibly remove Sandra’s underwear during a contraction (after Sandra had stated she would wear her own and consented to it being cut off in the event of an emergency), Sandra requested Dr. H come into the room, where she clearly stated she would no longer allow the nurse into her room and requested a new one. The charge nurse was brought in to inquire about the situation, and informed Sandra that a patient advocate would be in later to take a statement.
11:00pm – Sandra receives a new nurse, Lauren!
11:05pm – Cervical check: 3cm, 70%, - 3 station. I assure Sandra that despite the small amount of dilation, the effacement is a good sign and progress is still happening. Dr. H mentions “dip things” that baby’s HR isn’t doing during contractions and begins threatening a general Cesarean.
11:15pm – Sandra peed
11:37pm – Sandra agreed to an epidural after several threats from Dr. H of a general Cesarean. It was a tense moment and it was obvious she was agreeing at that moment to get Dr. H to stop harassing her.
11:55pm – Epidural placed
11.07.2011
1-3am – Sandra was able to get some sleep.
4:47am – Cervical check: 10cm, 100%, was told at +3 station. I asked for clarification, as +3 is considered crowning, but was told I was incorrect and +4 was crowning.
5:30am – Sandra begins pushing, but is not feeling much of anything and is having trouble making progress with her pushes.
5:50am – An internal monitor is placed after a short discussion with Dr. H. She was not happy that the EFM could not keep constant track of baby’s HR. Sandra asked for a moment to discuss the option, but was told no and the IFM was screwed into baby’s head. This is actually against the law, as it is not informed consent, and Sandra did not verbally agree to the internal monitor before it was placed.
6:14am – Sandra’s nurse informs her that she would not have had Sandra start pushing when she did because she didn’t think it was time yet to push and that baby was not at +3 station, as indicated by Dr. H. She confirmed my knowledge of +3 station being crowning. She did not tell us baby’s exact station at that point (she was using her fingers to help Sandra feel where to push), but my guess was it was more along the lines of +1 or even 0 station.
6:15am – Oxygen started for Sandra.
6:30am (time is approximate) – “The Fight” Dr. H entered the room and said it was time for a C-section. Sandra refused. Dr. H started snapping her fingers and telling her the baby would die or have Cerebral Palsy and Sandra needed a C-section immediately. Sandra refused again, stating, “If this were really an emergency we wouldn’t be having this conversation. I’m asking you for more time.” During the conversation, Sandra is pushing with all her might during contractions. John is becoming audibly upset (I can hear him gasping and groaning behind me) during the conversation.
Dr. H keeps telling Sandra she needs a Cesarean and Sandra continues to refuse and ask for more time. She also questions Dr. H on having her push sooner than she should have. Sandra eventually tells Dr. H she would like to speak with another doctor; that she would like a second opinion. Dr. H says, “Okay fine,” looks at John and says, “John, what do you think?” She then looks back at Sandra and says in a sharp tone, “There’s your second opinion.” John was obviously very scared and upset and advised Sandra to listen to Dr. H and have the repeat Cesarean.
Sandra calmly looked at John and said, “John, I know you’re worried, but I know nothing is wrong. If there was an actual emergency, we wouldn’t be having this conversation and I’d already be in surgery.” Sandra then told Dr. H that she had just been wanting to section her from the moment she got there, to which Dr. H said, “That’s not true.” (Please see notes from 7:15pm) Sandra finally convinced Dr. H to leave the room for a few minutes. She asked what I thought and I told her I did not have any experience with a high fetal HR* and only minor decels (the reasoning Dr. H was giving), but that my gut was telling me the same thing hers was telling her: that baby was fine.
Just then, the nurse Lauren walked in and said, “You don’t need a section. I just told Dr. H your baby looks better than the other one I have laboring in the next room and she’s not a VBAC. Dr. H is out there talking about shoulder dystocia, not the baby’s heart rate.” Sandra discussed hiring a new doctor at that point and the nurse gave some information on how that might play out.
Dr. H keeps telling Sandra she needs a Cesarean and Sandra continues to refuse and ask for more time. She also questions Dr. H on having her push sooner than she should have. Sandra eventually tells Dr. H she would like to speak with another doctor; that she would like a second opinion. Dr. H says, “Okay fine,” looks at John and says, “John, what do you think?” She then looks back at Sandra and says in a sharp tone, “There’s your second opinion.” John was obviously very scared and upset and advised Sandra to listen to Dr. H and have the repeat Cesarean.
Sandra calmly looked at John and said, “John, I know you’re worried, but I know nothing is wrong. If there was an actual emergency, we wouldn’t be having this conversation and I’d already be in surgery.” Sandra then told Dr. H that she had just been wanting to section her from the moment she got there, to which Dr. H said, “That’s not true.” (Please see notes from 7:15pm) Sandra finally convinced Dr. H to leave the room for a few minutes. She asked what I thought and I told her I did not have any experience with a high fetal HR* and only minor decels (the reasoning Dr. H was giving), but that my gut was telling me the same thing hers was telling her: that baby was fine.
Just then, the nurse Lauren walked in and said, “You don’t need a section. I just told Dr. H your baby looks better than the other one I have laboring in the next room and she’s not a VBAC. Dr. H is out there talking about shoulder dystocia, not the baby’s heart rate.” Sandra discussed hiring a new doctor at that point and the nurse gave some information on how that might play out.
A few minutes later, with Sandra more relaxed and in another position, the baby’s HR went down into the 160’s and was having normal decels during contractions. Dr. H came in with a much calmer demeanor and said baby looked better and she would allow Sandra to labor and push some more, but that she was “watching her like a hawk.” She then left the room.
7:00am – Shift change and we lost Lauren, but got Helen, who was also wonderful! Pushing really started to progress at that point and Sandra was feeling more confident in her pushing and reassured of her progress that Helen and I could see. Sandra asked nurse Helen to not call Dr. H in too soon for delivery. When it was finally time for Helen to call, she made the first call: “Tell Dr. H I need her in here for a delivery and she can walk.” No one came, so Helen called again a few minutes later: “Tell Dr. H I need her in here for a delivery and tell her not to walk!” Again, no one came. Finally, Helen made a third call: “Tell anyone available I need them in here NOW for a delivery!” Sandra delivered the baby’s head. She began yelling, “Help me! Help me! Help me!” Dr. H came running in, saying, “What’s wrong?!!?” She was all the way in the room before she saw baby’s head and quickly turned around to put on gloves and catch.
8:09am – Baby Emily is born! Sandra and John are overjoyed; I am immensely relieved and proud of Sandra; Helen is a wonderful cheerleader; and Dr H is shocked. Cord clamping is delayed for a couple minutes and John is able to cut the cord.
8:23am – Placenta is delivered intact; no problems or extra bleeding. Pitocin is given anyway as a precaution.
Sandra sustained a 3rd degree tear (please see Dr. H comments from 7:15am) and while Dr. H was doing repair work, she commented, “You proved me wrong,” and, “We should have a poster of you in our office: Successful VBAC!”
Emily Yesawich
8lbs 5oz
21” long
Apgar Scores: 8/9
* I have since asked a midwife about this type of scenario where the fetal HR is higher than normal and was told simply it just means the baby had a “higher baseline.” This makes sense, given the amount of stress Sandra was put under during the entire process.
To contact Jenn who is an AMAZING doula please go to her website: http://jenndoula.com
To contact Jenn who is an AMAZING doula please go to her website: http://jenndoula.com
No comments:
Post a Comment